Furcation Involvement in Periodontitis

Furcation Involvement

• Progression of periodontitis around teeth with multiple roots can lead to bone loss in the furcation area, which is the space between the roots.
• It is important to identify and measure furcation involvement because it is an indicator of disease progression and informs treatment decisions.

Nabers Probe

• The Nabers probe is a specialized periodontal probe designed for measuring furcations.
• It is similar in appearance to the BPE probe.
• It has two black bands:
  • The first band is 3-6mm from the tip.
  • The second band is 9-12mm from the tip.
• The probe is shaped like a pigtail to allow it to wrap around the tooth and access different entry points for furcation assessment.

Furcation Grades (Glickman 1953)

Grade 1

• The concavity just above the furcation entrance can be detected with the probe tip, however, the furcation probe cannot enter the furcation area.
• May be visible on a radiograph.

Grade 2

• The probe can partially enter the furcation, extending approximately 1/3 of the tooth’s width, but cannot completely pass through the furcation.
• May be visible on a radiograph.

Grade 3

• Lower Molars: The probe passes completely through the furcation between the mesial and distal roots.
• Upper Molars: The probe passes between the mesiobuccal and distobuccal roots and touches the palatal root.
• May be visible on a radiograph.

Grade 4

• The probe passes through the furcation completely (like Grade 3), but the entrance to the furcation is visible clinically due to tissue recession.

Challenges of Furcation Assessment

• Variances in tooth morphology (shape and structure) can make it difficult to access and accurately assess furcations with the Nabers probe.
• Variations in patient anatomy and the presence of soft tissue obscuring the entrance may also make access difficult.

This quiz explores the concept of furcation involvement in periodontitis, focusing on the use of the Nabers probe for assessment. It covers the classification of furcation grades and their implications for disease progression and treatment decisions. Test your understanding of these critical periodontal concepts!